Luiz Augusto Cassanha Galvão

Climate change, toxic pollution, and social inequities are converging to create new risks for workers and communities, particularly in the Global South. Yet occupational and environmental health research and policy still tend to address these stressors in isolation, not considering their interactions. To synthesize the main messages of the COP30 side event, “Amazon and Heat: Community-First Climate–Environment–Health Action from the Amazon Basin to Africa and Europe”, presented in the context of the LIMA2025 Conference on Occupational Medicine, and to propose a framework for integrated climate–environment–health action in work and community settings. This conference report and policy perspective are based on a narrative synthesis of presentations and discussions delivered during the COP30 side event and subsequently presented at LIMA2025 by researchers, Indigenous leaders, occupational health practitioners and civil society organizations from the Amazon Basin, Africa and Europe. Contributions were grouped into thematic domains: (1) climate and toxic exposures in the Amazon; (2) work and heat in African and Southern European settings; and (3) cross-cutting challenges and policy opportunities. The analysis followed a qualitative thematic approach. Across regions, participants described intersecting exposures to heat, toxic chemicals, air pollution, deforestation and psychosocial stress, disproportionately affecting workers, Indigenous peoples, traditional populations, pregnant women and children. Evidence from cohort studies, intervention projects, and remote-sensing analyses highlighted: (i) elevated mercury exposure and increasing microplastics and diesel contamination in Amazonian communities, alongside climate-sensitive food-system vulnerabilities; (ii) growing heat-related health risks among children and pregnant women in African cities; and (iii) dehydration, kidney dysfunction, and cardiometabolic risks among agricultural and construction workers in Southern Europe. Cross-cutting themes included exposure mixtures, inequities in access to care and justice, persistent data gaps, and the need for locally owned technologies, capacity building, and sustainable solutions. The side event catalyzed the development of an Amazon Climate–Environment–Health Consortium and a shared policy agenda. Integrated, equity-focused action on heat, toxic exposures, and work is essential for a just climate transition.

Hydro-meteorological and geological disasters can pose serious harm to community health, such as an increased risk of infectious diseases and related mortality. We conducted a scoping review to compile the available literature on the effects of hydro-meteorological and geological disasters on routine immunisation and vaccine-preventable disease (VPD) outbreaks among children and adolescents under 18 years. We searched Medline, Embase, Global Health, Scopus, and Web of Science for original studies and systematic reviews on the topic published by the 21st of October 2024. We included studies that quantitatively analysed the effect of any of the thirty Emergency Events Database (EM-DAT) recognised hydro-meteorological and geological disasters (or those fitting EM-DAT criteria) on a comprehensive list of World Health Organization (WHO)-recommended vaccines and the 23 diseases against which they prevent. We included 26 studies, of which 19 concerned with vaccine-preventable disease outbreaks and seven focused on routine immunisation disruption.. Our review indicates that floods, cyclones, droughts, extreme temperatures, tsunamis, and earthquakes may result in vaccine-preventable disease outbreaks and routine immunisation disruption, and identified young children and refugees as at-risk populations. Flooding was reported to be associated with water-borne and vector-borne vaccine-preventable disease outbreaks such as malaria. Poor water, sanitation and hygiene (WASH) were further recognised as facilitating conditions for vaccine-preventable disease outbreaks after disasters. The vaccination studies reported reduction in routine immunisation rates in the months following a disaster, considering infrastructural damage to health facilities and vaccine storage issues as common causes. Finally, there was significant knowledge gap on the effects of specific disasters (e.g., wildfires and volcanic eruptions) and diseases (e.g., influenza, yellow fever, malaria, and dengue).In conclusion, our review reinforce the need for better policies to ensure vaccine equity, resilient health system and safe WASH to prevent vaccine-preventable disease (VPD) outbreaks following hydro-meteorological and geological disasters.

Background Global climate change has led to an increase in both the frequency and intensity of extreme weather events, threatening food security by compromising food production and distribution, limiting physical and economic access to food and water, destabilising local and global prices, and exacerbating the spread of infectious and gastrointestinal diseases. This study aims to assess the impact of extreme weather events on food insecurity indicators across diverse populations and geographic contexts. Methods and analysis We will conduct a systematic review of observational studies, regardless of publication date or language, that quantify the effects of extreme weather events on food insecurity. The search will be conducted across 11 electronic databases using MeSH (Medical Subject Headings) terms, and references of included studies will be manually screened. The risk of bias will be assessed using the OHAT (Office of Health Assessment and Translation) tool. Where meta-analysis is deemed inappropriate, a narrative synthesis of the studies will be performed following the SWiM (Synthesis Without Meta-analysis) guidelines. If the data demonstrate sufficient compatibility and homogeneity, a meta-analysis will be performed to estimate proportions with 95% confidence intervals. Statistical heterogeneity will be evaluated using Cochran’s Q and I² statistics, and the certainty of evidence will be assessed following the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) framework. Discussion This systematic review will comprehensively examine food insecurity without restrictions on location, context, or definition, integrating diverse evidence to identify global patterns, contextual variations, and under-investigated issues. The findings are expected to inform future research and support the development of evidence-based public policies addressing food insecurity. A key limitation is the anticipated high heterogeneity across studies, which should be considered when interpreting results.

Globally, millions of lives are impacted every year by infectious diseases outbreaks. Comprehensive and innovative surveillance strategies aiming at early alert and timely containment of emerging and reemerging pathogens are a pressing priority. Shortcomings and delays in current pathogen surveillance practices further disturbed informing responses, interventions, and mitigation of recent pandemics, including H1N1 influenza and SARS-CoV-2. We present the design principles of the architecture for an early-alert surveillance system that leverages the vast available data landscape, including syndromic data from primary health care, drug sales, and rumors from the lay media and social media to identify areas with an increased number of cases of respiratory disease. In these potentially affected areas, an intensive and fast sample collection and advanced high-throughput genome sequencing analyses would inform on circulating known or novel pathogens by metagenomics-enabled pathogen characterization. Concurrently, the integration of bioclimatic and socioeconomic data, as well as transportation and mobility network data, into a data analytics platform, coupled with advanced mathematical modeling using artificial intelligence or machine learning, will enable more accurate estimation of outbreak spread risk. Such an approach aims to readily identify and characterize regions in the early stages of an outbreak development, as well as model risk and patterns of spread, informing targeted mitigation and control measures. A fully operational system must integrate diverse and robust data streams to translate data into actionable intelligence and actions, ultimately paving the way toward constructing next-generation surveillance systems.

UNSTRUCTURED Globally, millions of lives are impacted every year by infectious diseases outbreaks. Comprehensive and innovative surveillance strategies aiming at early alert and timely containment of emerging and reemerging pathogens are a pressing priority. Shortcomings and delays in current pathogen surveillance practices further disturbed informing responses, interventions, and mitigation of recent pandemics, including H1N1 influenza and SARS-CoV-2. We present the design principles of the architecture for an early-alert surveillance system that leverages the vast available data landscape, including syndromic data from primary health care, drug sales, and rumors from the lay media and social media to identify areas with an increased number of cases of respiratory disease. In these potentially affected areas, an intensive and fast sample collection and advanced high-throughput genome sequencing analyses would inform on circulating known or novel pathogens by metagenomics-enabled pathogen characterization. Concurrently, the integration of bioclimatic and socioeconomic data, as well as transportation and mobility network data, into a data analytics platform, coupled with advanced mathematical modeling using artificial intelligence or machine learning, will enable more accurate estimation of outbreak spread risk. Such an approach aims to readily identify and characterize regions in the early stages of an outbreak development, as well as model risk and patterns of spread, informing targeted mitigation and control measures. A fully operational system must integrate diverse and robust data streams to translate data into actionable intelligence and actions, ultimately paving the way toward constructing next-generation surveillance systems.

This compendium is a product of the Commission’s Green Recovery Task Force, a group of world-renowned economists, academics, environmentalists, and private sector experts convened to discuss and provide recommendations on how to build economic resilience and reduce inequality as we recover from the COVID-19 pandemic and work towards a more equitable, sustainable, and inclusive future.

Ao usar como referência a "autópsia social" da onda de calor de Chicago de 1995, o artigo examina as crises globais, particularmente as mudanças climáticas, seus quadros teóricos e as informações disponíveis para analisar o problema. Em comparação com o quadro de autópsia social, o modelo analítico atual é insuficiente para revelar os processos sociais e políticos subjacentes das crises globais. A ausência de um quadro analítico adequado desafia o estabelecimento de políticas públicas adequadas para enfrentar a atual crise global. Isso também favorece a "naturalização" dos processos, escondendo o componente político-social, que se revela como uma evidência de saúde, mas não como um processo social de longo prazo e determinante. Palavras-chave: Mudança climática. Agenda 2030. Autópsia social. desnaturalização de desastres. Vulnerabilidade socioambiental. ODS3.

RESUMO O presente artigo analisa, de forma preliminar, as principais posições e respostas de instituições-chave do sistema multilateral das Nações Unidas, como a Assembleia Geral (AGNU) e a Secretaria Geral, e sua agência especializada em saúde, a Organização Mundial da Saúde (OMS), quanto à pandemia pela Covid-19, no período compreendido entre janeiro e maio de 2020. Usando como metodologia a análise de conteúdo dos principais documentos produzidos no âmbito do referido sistema multilateral, identifica a amplitude dessa abordagem, mas também seus limites, assim como os conflitos inerentes a um mundo dividido, que traduzem as disputas de atores políticos relevantes da cena mundial, transferidas também para o campo da saúde global. Ao final, aponta questões fundamentais a serem resolvidas no âmbito de um multilateralismo fraturado e enfraquecido.